KELLY SULLIVAN,M.D.,P.C. (NPI# 1134309198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134309198 |
| Entity Type | Organization |
| Organization Name | KELLY SULLIVAN,M.D.,P.C. |
| Other Organization Name | PLASTIC & RECONSTRUCTIVE SURGERY OF ANNAPOLIS |
| Practice Address |
888 Bestgate Rd Suite 208 Annapolis MD 21401-3091 |
| Practice Telephone | 4105711280 |
| Practice Fax Number | 4105711288 |
| Mailing Telephone | 4105711280 |
| Mailing Fax Number | 4105711288 |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2007-11-07 |
| Authorized Official Name | DR. KELLY M SULLIVAN (PRESIDENT/OWNER) |
| Authorized Official Telephone | 4105711280 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Plastic & Reconstructive Surgery of Annapolis | Doing Business As Name - Organization |
| Street Address |
888 BESTGATE RD SUITE 208 |
| City | ANNAPOLIS |
| State | MD |
| Zip Code | 21401-3091 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316948508 | Louis K Essandoh | Internal Medicine | 888 Bestgate Rd, Suite 211, Annapolis, MD 21401-3091 | 2005-08-10 |
| 1679901417 | Cardiology Associates LLC | Specialist | 888 Bestgate Rd, Suite 211, Annapolis, MD 21401-3091 | 2013-10-14 |
| 1891130209 | Anne Arundel Physician Group LLC | Internal Medicine | 888 Bestgate Rd, Suite 208, Annapolis, MD 21401-3091 | 2013-04-30 |
| 1467795062 | Jennifer Marie Thompson | Pharmacist | 888 Bestgate Rd, Annapolis, MD 21401-3091 | 2013-04-02 |
| 1396086641 | Kim P Hudyma | Pharmacist | 888 Bestgate Rd, Annapolis, MD 21401-3091 | 2013-03-12 |
| 1205160736 | Jerome Segal, M.d., P.C. | Internal Medicine | 888 Bestgate Rd, Suite 211, Annapolis, MD 21401-3091 | 2009-10-01 |
| 1699954750 | Gregory A. Mitchell, Md, Pa | Specialist | 888 Bestgate Rd, Suite 211, Annapolis, MD 21401-3091 | 2007-10-25 |
| 1679765481 | Jerome Segal | Internal Medicine | 888 Bestgate Rd, Suite 208, Annapolis, MD 21401-3091 | 2007-08-15 |
| 1164622064 | Elizabeth Anne Reineck | Internal Medicine | 888 Bestgate Rd, Suite 208, Annapolis, MD 21401-3091 | 2007-07-19 |
| 1235335589 | Mairead M O'reilly | Dentist | 888 Bestgate Rd, Suite 301, Annapolis, MD 21401-3091 | 2007-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497377154 | Michael Khorsandi | Student in an Organized Health Care Education/Training Program | 2001 Medical Parkway, Clatanoff Pavillon, Gmw Office, Annapolis, MD 21401 | 2020-05-15 |
| 1275172033 | Katrice N Nelson | Massage Therapist | Wellsview Cottage Center, 613 Ridgely Avenue, Annapolis, MD 21401 | 2019-12-27 |
| 1548803521 | Victoria Reimnitz | Behavioral Analyst | 2028 Indusrtrial Dr, Ste B&c, Annapolis, MD 21401 | 2019-10-23 |
| 1700438140 | Emily Megan Burke | Nurse Practitioner | 200 Forbes St Annapolis, Md 21401, Suite 200, Annapolis, MD 21401 | 2019-07-16 |
| 1316504848 | Sherina Maryam Shamsa | Counselor | 1830 Forest Drive, Suite H-2, Annapolis, MD 21401 | 2019-05-21 |
| 1497225288 | Jerilyn Deitch | Speech-Language Pathologist | Anne Arundel County Public Schools, 2644 Riva Rd, Annapolis, MD 21401 | 2018-12-05 |
| 1487124038 | Lucinda W Mimms | Speech-Language Pathologist | 2644 Riva Rd., Annapolis, MD 21401 | 2018-11-27 |
| 1487145496 | Michelle Baudean | Behavior Technician | 1919 West St Ste 201, Annapolis, MD 21401 | 2018-05-24 |
| 1730678954 | Stephanie Ruth Streb | Registered Nurse | 130 Admiral Cochrane Dr Ste 103, Annapolis, MD 21401 | 2018-05-02 |
| 1780183947 | Annapolis Sleep Center LLC | Clinic/Center | 2451 Riva Rd, Annapolis, MD 21401 | 2018-02-02 |
| Find all providers in zip 21401 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164682746 | Claire Susan Duggal | Surgery | 621 Ridgely Ave 401, Annapolis, MD 21401-1099 | 2008-06-17 |
| 1134416688 | Anne Arundel Physician Group LLC | Surgery | 2000 Medical Pkwy, Suite 200, Annapolis, MD 21401-3742 | 2011-07-06 |
| 1831105329 | Kelly M Sullivan | Surgery | 888 Bestgate Road, Suite 208, Annapolis, MD 21401 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346713286 | Faulkner Plastic Surgery | Surgery | 6000 Executive Blvd Ste 204, North Bethesda, MD 20852-3803 | 2019-01-03 |
| 1043509748 | Salih Colakoglu | Surgery | 601 N Caroline St # 8152c, Baltimore, MD 21287-0006 | 2011-04-04 |
| 1376786418 | Emile Nathaniel Brown | Surgery | 1838 Greene Tree Rd Ste 370, Pikesville, MD 21208-7102 | 2009-04-17 |
| 1487813358 | Jerome S Plasse Md Pa | Surgery | 10085 Red Run Blvd #405, Owings Mills, MD 21117 | 2008-06-05 |
| 1073793501 | Bradley C Robertson Md L L C | Surgery | 1 Barrington Place, Suite 106, Bel Air, MD 21014-5607 | 2007-11-13 |
| 1093875288 | James E. Vogel | Surgery | 4 Park Center Ct, 100, Owings Mills, MD 21117-5611 | 2006-12-11 |
| 1750463964 | Stephane Corriveau | Surgery | 5530 Wisconsin Ave Ste 711, Chevy Chase, MD 20815-4401 | 2006-10-19 |
| 1477584753 | Alyson Delane Wells | Surgery | 10151 York Rd, Suites 112-114, Hunt Valley, MD 21030-3314 | 2006-07-05 |
| 1053381202 | Gary A Vela | Surgery | 8600 Snowden River Pkwy, Suite 308, Columbia, MD 21045-1982 | 2006-01-23 |
| 1104803782 | Atlantic Plastic Surgery PC | Surgery | 106 Milford St Ste 305, Salisbury, MD 21804 | 2005-12-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.